Hypertrophic Obstructive Cardiomyopathy, Bleeding History, and Acquired von Willebrand Syndrome: Response to Septal Myectomy


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Abstract

Bleeding with severe aortic stenosis is Iinked to acquired von Willebrand syndrome and loss of high-molecular-weight multimers of von Willebrand factor. Valve replacement resolves bleeding tendency and loss of high-molecular-weight multimers. We report outcomes in 5 patients with symptomatic obstructive hypertrophic cardiomyopathy and spontaneous gastrointestinal, mucosal, or excessive postsurgical bleeding in whom acquired von Willebrand syndrome was documented. All 5 patients underwent surgical septal myectomy with resolution of acquired von Willebrand syndrome.HMWM = high-molecular-weight muitimer; HOCM = hypertrophic obstructive cardiomyopathy: vWF = von Willebrand factor: vWF:Ag = vWF antigen; vWF:RCo = vWF ristocetin cofactor activity

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